Etude sur les attentes des élèves par rapport au médiateur scolaire

[Table des matières] I. Synthèse et propositions. II. Objectifs et méthodes de recherche. III. Participants et description des séances. IV. Résultats des groupes de discussion. 1. Le rôle et les fonctions du médiateur selon les élèves. 2. Les problèmes que peuvent rencontrer les élèves et les personnes ressources auxquelles ils peuvent s'adresser. 3. La rencontre avec le médiateur: obstacles, facteurs facilitants. 4. Le profil du médiateur idéal. 5. Evolution du rôle de la médiation scolaire. 6. La formation du médiateur. V. Références bibliographiques

Adolescent friendly health care: the experience of Switzerland

Lausanne University hospital, SwitzerlandBackground: The presentation will be based on the experience gained since twenty years at the Interdisciplinary Division for Adolescent Health (“DISA”/Department of Pediatrics, University hospital of Lausanne) and within the Euteach program (European Training in Effective Adolescent Care and Health / www.euteach.com). Objectives 1. Review how the principles of Adolescent Friendly Health Care can be implemented and applied within a multidisciplinary Unit. 2. Appraise how the quality of the health care services can be monitored through a regular certification process (ISO 9000:2001). 3. Emphasize some crucial ingredients of communication skills with young people. 4. Consider how communication skills can be taught/learned by health professionals. Content: The DISA, founded in 1998, stresses values such as an interprofessional approach to adolescent care, a holistic vision of health, integration of somatic and psychosocial issues, and youth empowerment. It provides each year 4000 consultations for around 1000 often disadvantaged young patients aged 12 to 20 with complex situations such as chronic conditions, functional disorders, gynecological/SRH problems, substance use, etc. Since 2006, the Unit is ISO certified (ISO 9000:2001): the certification process tackles several aspects of the everyday tasks of the Unit, such as guidelines governing health care and treatment, collaboration protocols, procedures for the follow-up of decisions, or surveys on adolescents’ satisfaction. The DISA has a strong training component, targeting medical/nursing students and residents. Their one to twelve months stays stress the importance of communication skills with adolescents, with the support of a special program of adolescent simulated patients (the presentation will display a video example). Conclusion: The DISA, now a WHO collaborating center in the field of school and adolescent health, is recognized as a center of excellence in adolescent medicine and health regionally, nationally, and internationally. By the end of the presentation, participants will have gained more insight into how to provide evidence-based effective health care to adolescents

Adolescent resilience and empowerment: a concept for clinical care and community health

Lausanne University hospital, SwitzerlandBackground: Resilience can be defined as a process by which individuals cope with and overcome the adverse conditions they have faced or currently face, such as a chronic condition or living in a deprived environment. The lessons that this concept bring can be used to empower young people in nearly all types of setting and circumstances. Objectives 1. Review how the concept of resilience was born and has been used over time 2. Apply the concept of resilience and empowerment in the everyday care of adolescents 3. Implement empowerment approaches in the design of community health promotion interventions Content: Using clinical vignettes, the presentation will illustrate how a health care provider can use the concept of resilience. It will stress the importance of a network approach in delivering health care to adolescents, as well as the importance to associate curative and preventive aspects of any investigation or treatment. It will exemplify the up-to-date concept of shared decision making and some of the ethical issues which it includes. Then, the presentation will focus on some concrete examples as how to implement empowerment strategies in the design, the implementation and the evaluation of preventive / health promotion interventions. It will emphasize the necessity to adopt an inter sectorial approach and will outline the advantages and pitfalls of the integration of young people in any program and how to address them. Conclusion: By the end of the presentation, participants will have gained more insight in how to provide participatory health care to adolescents and how to promote youth contribution in health promoting interventions

Selecting Benchmarks Combinations for the Evaluation of Multicore Throughput

Most high-performance processors today are able to execute multiple threads of execution simultaneously. Threads share processor resources, like the last-level cache, which may decrease throughput in a non obvious way, depending on threads characteristics. Computer architects usually study multiprogrammed workloads by considering a set of benchmarks and some combinations of these benchmarks. Because cycle-accurate microarchitecture simulators are slow, we want a set of combinations that is as small as possible, yet representative. However, there is no standard method for selecting such sample, and different authors have used different methods. It is not clear how the choice of a particular sample impacts the conclusions of a study. We propose and compare different sampling methods for defining multiprogrammed workloads for computer architecture. We evaluate their effectiveness on a case study, the comparison of several multicore last-level cache replacement policies. We show that random sampling, the simplest method, is robust to define a representative sample of workloads, provided the sample is big enough. We propose a method for estimating the required sample size based on fast approximate simulation. We propose a new method, workload stratification, which is very effective at reducing the sample size in situations where random sampling would require large samples.Aujourd'hui, la plupart des processeurs hautes performances sont capables d'exécuter plusieurs flots d'exécution simultanément. Ces flots d'exécution partagent les ressources du processeur, comme le cache de dernier niveau, ce qui peut réduire le débit d'exécution de manière difficilement prévisible, selon les caractéristiques de ces flots. Les architectes étudient généralement les charges multitâches en considérant un ensemble de charges de référence et des combinaisons de ces charges de référence. Comme les simulateurs précis au cycle près sont lents, nous voulons un ensemble de combinaisons qui soit aussi petit que possible, mais représentatif. Cependant, il n'existe pas de méthode standard pour la sélection de ces échantillons et différents auteurs ont utilisé différentes méthodes. Il n'est pas clair en quoi le choix d'un échantillon en particulier a une incidence sur les conclusions d'une étude. Nous proposons et comparons différentes méthodes d'échantillonnage permettant de définir des charges multitâches pour l'architecture des ordinateurs. Nous évaluons leur efficacité sur une étude de cas : la comparaison de plusieurs politiques de remplacement pour le cache de dernier niveau. Nous montrons que l'échantillonnage aléatoire, la méthode la plus simple, est robuste pour définir un échantillon représentatif de la charge de travail, à condition que l'échantillon soit assez grand. Nous proposons une méthode d'estimation de la taille de l'échantillon nécessaire basée sur une simulation rapide approximative. Nous proposons une nouvelle méthode, la stratification de charges multitâches, qui est très efficace pour réduire la taille de l'échantillon dans les cas où un échantillonnage aléatoire requerrait de grands échantillons

Adolescent resilience and empowerment: a concept for clinical care and community health

Lausanne University hospital, SwitzerlandBackground: Resilience can be defined as a process by which individuals cope with and overcome the adverse conditions they have faced or currently face, such as a chronic condition or living in a deprived environment. The lessons that this concept bring can be used to empower young people in nearly all types of setting and circumstances. Objectives 1. Review how the concept of resilience was born and has been used over time. 2. Apply the concept of resilience and empowerment in the everyday care of adolescents. 3. Implement empowerment approaches in the design of community health promotion interventions. Content: Using clinical vignettes, the presentation will illustrate how a health care provider can use the concept of resilience. It will stress the importance of a network approach in delivering health care to adolescents, as well as the importance to associate curative and preventive aspects of any investigation or treatment. It will exemplify the up-to-date concept of shared decision making and some of the ethical issues which it includes. Then, the presentation will focus on some concrete examples as to how to implement empowerment strategies in the design, the implementation, and the evaluation of preventive / health promotion interventions. It will emphasize the necessity to adopt an inter-sectorial approach and will outline the advantages and pitfalls of the integration of young people in any program and how to address them. Conclusion: By the end of the presentation, participants will have gained more insight into how to provide participatory health care to adolescents and how to promote youth contribution in health-promoting interventions

How to adress self-harm and suicide at an individual and community level?

Lausanne University hospital, SwitzerlandBackground: Eastern European countries exhibit some of the most elevated rates of suicide in the world. According to UNICEF, the suicide rate among adolescents in Moldova is increasing in the last years (by 40% from 2007 to 2011), being 10 times higher among boys than in girls. This situation, it says, requires more active intervention to prevent mental health problems among adolescents, with special attention to boys. Objectives 4. Define the concepts of self-harm and suicide, review some epidemiological data 5. Identify risk factors for self-harm and suicide among adolescents 6. Adopt a systematic approach in dealing with suicidal conducts of adolescents 7. Review some evidence-based preventive strategies of adolescent self-harm and suicide Content: The presentation will review some international data on suicide, focusing on the rates of suicide among adolescents. Using a concept developed and used internationally, it will provide a tool to systematically assess the risk for a young patient of committing suicide, and how to tackle this type of situations. This clinical strategy stresses the appraisal of both risk and protective factors. It also emphasizes the adoption of a network approach to individual treatment and prevention. Then, the presentation will focus on some concrete examples as how to implement strategies to prevent self-harm and suicide, as well as how to create environments which promote mental health and coping strategies among adolescents, building on the session on resilience and empowerment. It will insist on the interest of using media technologies (including phone calls and internet), such as the one used by the Moldavian Suicide Prevention Lifeline, which operates in the evening hours as anonymous chat. Conclusion: By the end of the presentation, participants will have gained more insight in how to develop effective strategies in identifying and addressing situations of adolescent self-harm and suicide, and how to prevent them on an individual and community levels

Cannabis and tobacco use: where are the boundaries? A qualitative study on cannabis consumption modes among adolescents

The purpose of this article is to identify tobacco and cannabis co-consumptions and consumers' perceptions of each substance. A qualitative research including 22 youths (14 males) aged 15-21 years in seven individual interviews and five focus groups. Discussions were recorded, transcribed verbatim and transferred to Atlas.ti software for narrative analysis. The main consumption mode is cannabis cigarettes which always mix cannabis and tobacco. Participants perceive cannabis much more positively than tobacco, which is considered unnatural, harmful and addictive. Future consumption forecasts thus more often exclude tobacco smoking than cannabis consumption. A substitution phenomenon often takes place between both substances. Given the co-consumption of tobacco and cannabis, in helping youths quit or decrease their consumptions, both substances should be taken into account in a global approach. Cannabis consumers should be made aware of their tobacco use while consuming cannabis and the risk of inducing nicotine addiction through cannabis use, despite the perceived disconnect between the two substances. Prevention programs should correct made-up ideas about cannabis consumption and convey a clear message about its harmful consequences. Our findings support the growing evidence which suggests that nicotine dependence and cigarette smoking may be induced by cannabis consumptio

Chronic illness, life style and emotional health in adolescence: results of a cross-sectional survey on the health of 15-20-year-olds in Switzerland

The objective was to evaluate the prevalence of chronic conditions (CC) in adolescents in Switzerland; to describe their behaviour (leisure, sexuality, risk taking behaviour) and to compare them to those in adolescents who do not have CC in order to evaluate the impact of those conditions on their well-being. The data were obtained from the Swiss Multicentre Adolescent Survey on Health, targeting a sample of 9268 in-school adolescents aged 15 to 20 years, who answered a self-administered questionnaire. Some 11.4% of girls and 9.6% of boys declared themselves carriers of a CC. Of girls suffering from a CC, 25% (versus 13% of non carriers; P=0.007) and 38% of boys (versus 25%; P=0.002) proclaimed not to wear a seatbelt whilst driving. Of CC girls, 6.3% (versus 2.7%; P=0.000) reported within the last 12 months to have driven whilst drunk. Of the girls, 43% (versus 36%; P=0.004) and 47% (versus 39%; P=0.001) were cigarette smokers. Over 32% of boys (versus 27%; P=0.02) reported having ever used cannabis and 17% of girls (versus 13%; P=0.013) and 43% of boys (versus 36%; P=0.002) admitted drinking alcohol. The burden of their illness had important psychological consequences: 7.7% of girls (versus 3.4%; P=0.000) and 4.9% of boys (versus 2.0%; P=0.000) had attempted suicide during the previous 12 months. Conclusion: experimental behaviours are not rarer in adolescents with a chronic condition and might be explained by a need to test their limits both in terms of consumption and behaviour. Prevention and specific attention from the health caring team is necessar

Alternative Schemes for High-Bandwidth Instruction Fetching

Future processors combining out-of-order execution with aggressive speculation techniques will need to fetch multiple non-consecutive instruction blocks in a single cycle to achieve high-performance. Several high-bandwidth instruction fetching schemes have been proposed in the past few years. The Two-Block Ahead (TBA) branch predictor predicts two non-consecutive instruction blocks per cycle while relying on a conventional instruction cache. The trace cache (TC) records traces of instructions and delivers multiple non-consecutive instruction blocks to the execution core. The aim of this paper is to investigate the pros and cons of both approaches. Maintaining consistency between memory and TC is not a straightforward issue. We propose a simple hardware scheme to maintain consistency at a reasonable performance loss (1 to 5%). We also introduce a new fill unit heuristic for TC, the mispredict hint, that leads to significantly better performance (up to 20 %). This is mainly due to better prediction accuracy results and TC miss ratios. TBA requires double-ported or bank-interleaved structures to supply two non-consecutive blocks in a single cycle. We show that a 4-way interleaving scheme is cost-effective since it impairs performance by only 3 to 5%. Finally, simulation results show that such an enhanced TC scheme delivers higher performance than TBA when caches are large, due to a lower branch misprediction penalty and a higher instruction bandwidth on mispredictions. When the hardware budget is smaller, TBA outperforms TC because of a higher TC miss ratio and branch misprediction rate